Individual
MR. DOMINIC J MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
44199 MONROE ST, INDIO, CA 92201-3096
(760) 863-8341
Mailing address
44199 MONROE ST, INDIO, CA 92201-3096
(760) 863-8341
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
GKJBRVZWLCYMONP
CA
Other
Enumeration date
10/07/2021
Last updated
05/10/2023
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